Province seeks to return organs

Ontario's chief forensic pathologist, Dr. Michael Pollanen (left), speaks at a news conference in Toronto on Wednesday, June 13, 2012 as the province's chief coroner, Dr. Andrew McCallum (right), looks on. Hundreds of inquiries have come in over the past week from relatives asking after organs belonging to dead family members, Pollanen said Thursday. THE CANADIAN PRESS/Colin Perkel

For some Ontario families, who had loved ones undergo an autopsy prior to June 14, 2010, all may not have been as it seemed at the funeral.

The Ontario Forensic Pathology Service has 4,000 organs still in storage from autopsies dating back to the 1970s and is trying to connect with families unaware of the remains’ existence before a June 14 deadline to begin disposing of them.

Prior to 2010, it was common practice not to inform families that organs had been retained.

“In looking back, we could have communicated more openly with families than in the past,” said Dr. Michael Pollanen, chief of forensic pathology for the Ontario Forensic Pathology Services.

“We have strengthened our practices.

“I’m just sorry for the stress it may cause families. I view this to be an evolution of medical ethics.”

The Ontario Forensic Pathology Service has been running newspaper ads nationally since June 14, 2012 in hopes of getting in touch with the affected families.

About 460 cases have been re-opened since the campaign of reunification began and organs have been returned in 80 of those cases.

Other families have chosen not to take possession of the organs when matches were found.

Pollanen said his office has received about 1,500 inquiries about the program.

The retained organs have been stored at the hospital or pathology unit where the autopsy was performed. After June 14, officials are required by law to begin disposing of the unclaimed remains by cremation.

The effort to inform families that organs of their loved ones may remain in storage is a result of changes to the Coroners Act in June, 2010.

Regulation 180 of the act requires families to be notified of the retained organs and written direction sought on how the family wishes to have the remains disposed of.

Under terms of the current Coroner’s Act, if an autopsy is ordered to be performed, the family’s consent is not required to retain the organs. Consent to retain organs must be sought from the chief forensic pathologist or someone acting on his behalf.

Pollanen said there are about 1,500 coroner investigations and 6,000 autopsies performed a year in Ontario.

Though it’s been relatively rare, Families First Funeral Home and Tribute Centre president Brian Parent said some area families have been affected by the revised rules of organ retention.

“It doesn’t happen a lot, but we’ve had probably about one a year,” said Parent of organs being returned.

“Most cemeteries give the option for internment or cremation. The cremated remains could also be buried in the existing grave.”

Parent said it’s much more the norm for organs to be returned quickly with the rest of the remains.

“At the time of the autopsy, the coroner makes every effort to return all the remains,” Parent said.

Parent said experience has shown him families react differently to having the remains of the deceased returned fully intact.

“It’s important for some families to have the deceased fully present for visitation,” Parent said.

“Some families are more concerned about the cause of death. They’re happy to allow for there to be a full examination.”

Pollanen said the hardest decisions about how to proceed revolved around being sensitive to families. He said consultations were held with bioethicists and other physicians before a policy was crafted.

It was decided to make a full public disclosure that the organs existed and then let those families interested in pursuing their recovery approach Forensic Pathological Services.

“Just calling people out of the blue could’ve ripped open a lot of painful memories,” Pollanen said. “There’s been a wide range of reactions from families.

“Some people don’t want to engage the issue. Other people want the organs for burial with the body.”

Pollanen said the new guidelines formalize what are considered best practices for the province’s pathologists.

In the past, each doctor or hospital had its own policy of how the remains would be disposed of following an autopsy. Pollanen described the profession’s past approach as being ‘paternalistic’ rather than transparent.

“Doctors were trying to protect families during a painful time, but now medicine is much more transparent,” Pollanen said. “This is what we’re trying to do now.”

Pollanen said medical advances have allowed pathologists to pinpoint the cause of death more accurately and quickly. There’s usually no longer the requirement to retain organs for further testing as there had been in the past.

The changes also help address the spiritual and moral questions of retaining and disposing of organs without the consent of the family.

Pollanen added there’s never been legal issue at stake as the Coroner’s Act outlined the coroner’s right to take possession of a body and retain organs for medical and legal purposes.

Any immediate relative (spouse, child or parent, sibling) or official representative of the deceased’s estate can make an inquiry about retained organs by calling the toll-free number 1-855-564-4122, e-mailing organretention@ontario.ca or visiting the website Ontario.ca/organretention.

To make an inquiry you will have to supply some details about the deceased’s birth, date and place of death and file some forms authorizing the release of the autopsy’s information.

If an organ has been retained, a written authorization to send the organ to a funeral home or to have it disposed in another fashion is required.

The Pathology Service and the Office of the Coroner will cover all costs of shipping, cremation and burial in reuniting the remains of the deceased in cases where a match is found.

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